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Swallowing is a complex motor skill that requires the coordination of many nerves and muscles. When the muscles involved in swallowing are weak, it can lead to swallowing difficulties, known as dysphagia, which can cause serious health issues. Fortunately, there are swallowing exercises that can help improve muscle strength and coordination, making it easier to swallow. These exercises are typically prescribed by a speech-language pathologist or physician and should be performed under their guidance to ensure safety and effectiveness. With consistent practice, individuals can improve their swallowing function and reduce the risk of associated complications.
| Characteristics | Values |
|---|---|
| Swallowing exercises | Effortful swallow, Mendelsohn Maneuver, Isokinetic (dynamic) Shaker, Supraglottic Maneuver, Yawn, etc. |
| Who should perform them? | Speech-language pathologists, occupational therapists, physical therapists, or doctors |
| When to perform them? | When directed by a medical professional |
| How often to perform them? | Depends on the exercise and the patient; your doctor or therapist will tell you how often to do the exercises and how many times to repeat each one |
| How to perform them? | Depends on the exercise; your doctor or therapist will give you instructions |
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What You'll Learn
Larynx-closing exercises
Before initiating larynx-closing exercises, it is recommended to consult with your SLP or healthcare provider to determine the appropriate positioning. For instance, they may advise performing the exercises while out of bed to maximize their effectiveness. It is also crucial to eliminate distractions and choose a quiet environment to ensure your full concentration during the exercises.
- Collect a small amount of saliva in your mouth.
- Take a deep breath and hold it.
- Swallow the saliva while continuing to hold your breath.
- Immediately after swallowing, cough to clear any remaining saliva or food particles that may have entered your larynx.
- Finally, exhale.
Once you become comfortable with this exercise, you can increase its intensity by adding a small piece of food to your mouth and performing the same steps. It is important to start with a tiny portion of food and gradually increase the amount as your strength improves. Additionally, you can incorporate the use of a drinking straw and pieces of paper to further challenge your swallowing muscles. Remember to always follow the guidance of your healthcare provider or SLP when advancing your exercises.
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Effortful swallow
The "effortful swallow" technique, also known as the Modified Valsalva maneuver or the "Hard Swallow", is a swallowing exercise aimed at strengthening the muscles involved in the complex motor skill of swallowing. This technique is particularly useful for individuals with neurological conditions such as cerebral palsy, dementia, cervical spine injury, or a stroke, who may experience difficulty swallowing, a condition known as dysphagia.
The effortful swallow involves swallowing with great effort and gusto, recruiting more motor units and increasing the demand on the muscles to create a training effect. This technique helps protect the airway by ensuring that food or liquids do not pool in the mouth or pharynx after swallowing, which can occur due to muscle weakness.
To perform the effortful swallow, patients are often instructed to pretend to "swallow a grape whole" or "swallow a vitamin without water". For those with excess saliva or mucus in the throat, this technique can help clear the throat and improve swallowing function. Visual reminders, such as Post-It notes or wearing a brightly coloured bracelet, can also be used to prompt patients to practice the effortful swallow throughout the day.
The effortful swallow can be performed as an indirect therapy technique, without food, or as a direct therapy technique, during the swallowing of food or liquids. It is important to note that swallowing exercises should only be performed under the guidance of a medical professional, such as a speech-language pathologist, occupational therapist, or physical therapist, who can develop a safe and effective treatment plan.
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Mendelsohn Maneuver
The Mendelsohn Maneuver is a technique used to treat patients with pharyngeal dysphagia, a disorder that causes difficulty swallowing. This condition can lead to serious complications such as aspiration pneumonia, an infection caused by food particles entering the lungs. The Mendelsohn Maneuver is often performed as part of a rehabilitative exercise program or as a compensatory strategy to aid the passage of food through the pharynx more efficiently.
The technique involves the voluntary prolongation of hyolaryngeal elevation at the peak of the swallow. In simple terms, this means squeezing and holding the larynx at the highest point during swallowing. This can be achieved by taking a deep breath, holding it, and then swallowing while maintaining the breath. The participant is instructed to swallow "long and strong", with a squeeze at the peak of the swallow for 3 to 4 seconds.
This maneuver has been found to increase laryngeal elevation and maximal hyoid superior displacement, resulting in a prolonged duration of opening of the upper esophageal sphincter (UES). The UES is a critical component in the act of swallowing, as it allows food to pass from the pharynx into the esophagus. By prolonging the opening of the UES, the Mendelsohn Maneuver helps facilitate the passage of food and improves swallowing function.
To perform the Mendelsohn Maneuver effectively, it is essential to seek guidance from a medical professional, such as a speech-language pathologist, occupational therapist, or physical therapist. They can provide personalized instructions, ensuring the exercise is performed correctly and safely. Additionally, they can develop a tailored program to help you progress safely to more challenging exercises. It is important to note that swallowing exercises, including the Mendelsohn Maneuver, should only be performed under the supervision and recommendation of a qualified healthcare provider.
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Yawn
During a yawn, your diaphragm and rib muscles contract, causing you to breathe in air, and your lower jaw opens, creating a "gaping" mouth. The tip of your tongue retracts and moves downward, and your larynx and hyoid bone also move downward with the help of certain contracting muscles. The rate at which you're breathing in air accelerates, and your soft palate and part of your pharynx rise. This is when you may hear an inhaling sound, and it is followed by a rapid exhale.
While yawning does not directly target the muscles used for swallowing, it does involve the powerful stretching and tensing of many muscles in the face, throat, and chest. Therefore, it may help to improve the strength and coordination of the muscles involved in swallowing, particularly those in the throat and face.
To incorporate yawning into your routine for improving swallowing muscles, you can try voluntary yawning exercises throughout the day. Start by taking a long, deep breath of air through your nose and mouth, and then yawn widely, stretching and tensing the muscles in your face, throat, and chest. Repeat this a few times, aiming for a few seconds of powerful muscle stretching and tensing with each yawn.
It is important to note that yawning should not be considered a replacement for specific swallowing exercises prescribed by a speech-language pathologist or other medical professional. These exercises are designed to target the specific muscles involved in swallowing and can help improve your swallowing function. Combining yawning exercises with the prescribed swallowing exercises can be a comprehensive approach to improving your swallowing muscles and function.
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Consult a medical professional
If you are experiencing difficulty swallowing, it is important to consult a medical professional, such as a speech-language pathologist, occupational therapist, or physical therapist. These specialists can help diagnose any underlying conditions and develop a tailored treatment plan to improve your swallowing muscles. Here are some reasons why seeking professional help is essential:
Diagnosis and Assessment
A speech-language pathologist or therapist will assess your swallowing function and identify the specific muscles or phases of swallowing that require improvement. They will also determine if there are any associated neurological or health conditions contributing to your difficulty swallowing, such as cerebral palsy, dementia, stroke, or other conditions that may require additional treatments.
Treatment Plan
Based on their assessment, the medical professional will develop a treatment plan that includes specific swallowing exercises tailored to your needs. This plan may include a combination of therapies, such as tongue-strengthening exercises, larynx-closure exercises, or other condition-specific exercises. They will guide you through the correct techniques to ensure safety and effectiveness.
Monitoring and Adjustment
Your progress will be closely monitored by your medical team through bedside swallowing exams, imaging tests, or other evaluations. They will also make any necessary adjustments to your treatment plan, including modifying your diet or exercise therapy, to ensure optimal results. Working collaboratively with your healthcare team will maximise your chances of a successful outcome.
Safety
Performing swallowing exercises without proper guidance can be risky. A medical professional will ensure that you perform the exercises correctly and safely, reducing the risk of choking or other complications. They will help you gradually work up to more challenging exercises, ensuring your safety and well-being throughout the treatment process.
Additional Support
In addition to exercises, a medical professional can provide dietary advice and recommendations for nutritional intake, which is crucial for maintaining overall health and preventing malnutrition or dehydration due to swallowing difficulties. They can also collaborate with other specialists as needed to address any related health conditions.
In summary, consulting a medical professional is essential for receiving a comprehensive evaluation, a tailored treatment plan, and ongoing support to improve your swallowing muscles and address any associated health concerns.
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Frequently asked questions
Dysphagia is a condition where individuals experience difficulty swallowing. This can lead to choking, excess saliva production, and aspiration pneumonia.
Consult a medical professional such as a physician or a speech-language pathologist. They will be able to assess your swallow function and determine if you have dysphagia.
There are several exercises that can help improve your swallowing muscles, including:
- Effortful Swallow: Collect saliva on your tongue, keep your lips closed and tight, then swallow as if you are swallowing a grape whole.
- Mendelsohn Maneuver: Place your middle three fingers on your Adam's Apple. Swallow and feel your Adam's Apple slide upward. Then, swallow again and squeeze your throat muscles to hold it in that position.
- Yawn: Open your mouth wide in a yawn and hold that position to strengthen the back of your tongue and throat muscles.
The frequency and number of repetitions of swallowing exercises depend on the patient and should be prescribed by a medical professional. It is recommended to only perform swallowing exercises under the care of a medical professional as there is a risk of choking.
Yes, once you have learned how to do the exercises under the guidance of a medical professional, you can practice them at home. However, it is important to first consult a medical professional to determine which exercises are safe and suitable for you.
